What you should know if your partner has bipolar disorder

A chronic illness like bipolar disorder can place heavy demands on a love relationship. Clinical social worker Sandy Lewis talks candidly about the emotional, financial and other realities of living with bipolar disorder. She offers advice on how to allow your partner to remain independent, provide the right kind of support while maintaining your own balance, communicate effectively, and let others in on the “secret”.

Falling in love is a heady experience. Unfortunately, this state never lasts indefinitely. No partner is perfect, and every intimate relationship brings with it its own challenges. Sooner or later many couples find themselves at a crossroads, with one or both wondering whether continuing the relationship is worth their while. 

One of the factors that may contribute to such a reality check is a chronic illness. When your partner has bipolar disorder, the unpredictable mood swings that characterise this disease and the stigma attached to mental illness tend to make things worse. “Unless bipolar disorder is effectively managed, a partner may feel as if they are perpetually living in crisis mode," cautions Sandy Lewis, head of therapeutic services at Akeso Psychiatric Clinics.

According to SADAG’s Bipolar Disorder Brochure, bipolar disorder is more than just a simple mood swing.

“You experience a sudden dramatic shift in the extremes of emotions. These shifts seem to have little to do with external situations. In the manic or ‘high’ phase of the illness you aren't just happy, you are ecstatic. A great burst of energy can be followed by a severe depression, which is the ‘low’ phase of the disease. Periods of fairly normal moods can be experienced between cycles. These cycles are different for different people. They can last for days, weeks, or even months.”

“When someone has bipolar disorder their mood, thought processes, actions, health, career, finances and relationships can all be affected by the condition,” Sandy explains. “Some partners are willing and able to act as caregivers.

“Others feel unable to cope with a life that is disrupted on so many levels. These feelings are normal and understandable. I want to state unequivocally that it is difficult to live with a partner with a serious mental illness - but it is not impossible.  

“The good news is that - unlike narcissism, borderline personality disorder and other conditions rooted in the personality - bipolar disorder is a mood disorder. Medication used to treat mood disorders control the levels and absorption of brain chemicals and can work very well. However, medication must be supported by lifestyle adjustments such as

• regular bedtimes

• a healthy eating pattern that stabilises blood sugar levels

• the avoidance of chemicals such as alcohol and drugs

• exercising in a sensible way

• effective stress management.

“A balanced, well-regulated lifestyle helps to prevent or flatten extreme mood swings.”

Out-of-control manic and depressive phases

“Some people with bipolar disorder experience the manic phase as pleasant because they feel energetic, creative and 'powerful'. It can unfortunately turn into a psychotic or delusional state in which they lose contact with reality. For example, they may impulsively buy a Ferrari, or act in a sexually irresponsible way.

“A manic phase can also be followed by a high-risk depressive phase, characterised by extreme fatigue, suicidal tendencies and possibly the inability to work.”

Image: Pexels

Clinical psychologist Dr. Elisa Mecco talks about the role menopause, PMS and appetite depressants can play - and how the cost-effective BrainWorking Recursive Therapy can help manage this disorder.

The effect of hospitalisation

“The out-of-control moods that characterize the disease can necessitate weeks or months in hospital. This puts a huge strain on a relationship. The household, children (if any), medical expenses, loss of income if the patient is unable to work, and other responsibilities fall on the partner's shoulders, in addition to their concern for their loved one in hospital.

"It is important that people realise that bipolar disorder cannot be cured - it can only be managed. Even when the person feels better, the illness remains part of the picture.

"Partners who are not sure whether they want to remain in this relationship in the long run need to know exactly what they are getting themselves into in order to make an informed decision."

Sandy’s relationship advice

If you are in a romantic relationship with someone who has bipolar disorder, Sandy recommends that you consider the following:

• If you are a calm, even-tempered person who handles stress well, who doesn’t easily grow anxious and can maintain or quickly regain your emotional balance, you will find the ups and downs of your partner's mental illness less disruptive. You need to be independent, to stand strong, and not be overly vulnerable. (There are cases where the partners of people with chronic illnesses prefer a co-dependent relationship because being in the role of the caregiver seems to give them the right to exist, but this is not healthy. In cases like these, it does not suit them when their partner gets better.)

• A happy, stable relationship is only possible when your partner takes responsibility for his or her own well-being.

Image: Pexels

“If you take on the role of a parent, you no longer have a partner in the true sense of the word - you have a child (or another child). The two of you need to come to an agreement that he or she will take their medication regularly, manage their lifestyle and stress levels, get regular medical check-ups and remain on the lookout for early warning signs of a manic or depressive episode. Encourage your partner to use a mood diary or mood chart. (You can find an example and instructions here. Akeso also provides patients and their family members with training in this regard.)

• Open communication can help prevent a setback. Give honest feedback to your partner, for example: "I see a change in your mood / behaviour."

• Acting in a hypercritical or controlling way is counterproductive. Allow your partner to remain independent and make their own decisions, otherwise the relationship of trust between you can be harmed.

• You can make it clear that, should your partner run the risk of becoming ill by not seeing to their own well-being, it will jeopardise your relationship. For a romantic relationship to remain healthy, each partner must remain an adult in their own right.

• Open communication is not only essential within the relationship, but also outside of it. Discuss the disease openly with friends and family, even if you run the risk of rejection. If your partner wants to keep their condition a secret, it will isolate you because you will be unable to ask for support.

• When you and your partner are having an argument, refrain from rubbing your partner's nose in their illness. This is a shaming technique and can trigger a relapse in someone who may already feel fragile. When you say: "I warned you – I told you so", a downward spiral of blame arises which could destroy the relationship.

• Find a support group in your area, or join an online group. You’ll get to know people in similar situations and may discover that you’re not faring badly at all. Beware of the thought: "If only I were a better person…"

• Consider professional help if you are staying in the relationship for no other reason than feelings of guilt or a keen sense of responsibility, or if you are afraid your partner will commit suicide if you end the relationship. If you feel you are being manipulated your resentment will grow, which is not in the best interests of either you or your partner.

• Bear in mind that a chronic illness can involve large expenses. For example, medical aid provides only 21 days of hospitalisation annually, and if this does not suffice the patient will need to go to a government hospital, become an outpatient, or pay private patient rates for psychiatric services. If your partner is unable to work at times, this will increase the financial burden.

• People dealing with a mental illness are extremely sensitive to stress. A traumatic experience such as a car hijacking can trigger an "episode" and lead to months of hospitalisation. Stress management includes avoiding risky situations, such as staying out late with friends who are drinking heavily.

• Even though people with bipolar disorder may fear being labelled or discriminated against (the latter is against the law), they should inform their employer of their condition.

Firstly, they may suddenly need to be hospitalised, which will necessitate an explanation. Secondly, it is unwise to accept projects that involve long working hours or inhumane deadlines. Even one stressful week can have dire consequences. Staying healthy should be their top priority, even if a promotion passes them by.

• If you are not yet married, it is wise to live together for a while so that you can find out how resilient you are. If you are considering having children, remember that bipolar disorder has a strong hereditary component.

• If you can honestly say that you have faced the reality of the disease and all of its facets, and that you still feel inextricably linked to your partner, this is a sure sign of unconditional love.

Contact details

Clinical social worker Sandy Lewis is the Compassion and Mental Wellness Lead for Netcare Hospitals and Akeso Clinics.

Akeso Psychiatric Clinics: https://www.akeso.co.za/ or 0861 435 787 (24 hour emergency contact).

This article originally appeared in rooi rose.

Images: Unsplash, unless indicated otherwise. Models used.

Please note:
This article is intended purely for educational purposes and should never replace professional evaluation or discussion. If you have suicidal thoughts, phone the free SADAG helpline at 0800 567 567 or SMS 31393 (both available 24/7) or contact a qualified medical professional.